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Kwashiorkor is a form of acute malnutrition that most commonly occurs in children. This condition is extremely serious and results from such severe protein deficiencies that a child experiences edema or swelling.

Other terms for kwashiorkor include:

  • protein malnutrition
  • malignant malnutrition
  • protein-calorie malnutrition

If a child experiences kwashiorkor, their family or others should seek immediate medical treatment for them.

What are the causes of kwashiorkor?

person holding bread representing malnutrition and famine.
A diet lacking adequate protein or nutrients can cause kwashiorkor.

Kwashiorkor is the result of severe malnutrition or lack of protein and, usually, calories as well.

A child may sometimes have a continued cereal- or grain-based diet that may have some calories but lacks sufficient nutrients and protein.

Proteins are responsible for maintaining fluid balance in the body. Without proteins, fluid shifts to areas it should not be.

This is what happens when someone has kwashiorkor.

Where is it most common?

Kwashiorkor usually occurs in those under 4 years of age, living in rural communities, particularly those in sub-Saharan Africa. It often occurs after a child is weaned and may no longer be getting the same nutrients and proteins in their regular diet.

The condition may occur in areas where there is a lack of food supply or famine or low levels of education about diet and nutrients.

Some people may experience the condition after a natural disaster or drought that knocks out the food supply of an area.

While kwashiorkor is very rare in children in the United States, an estimated 50 percent of seniors in nursing homes lack protein in their diets, according to the University of Florida Health.

Symptoms of kwashiorkor

Children with kwashiorkor are often extremely emaciated or thin but not always. Some of the symptoms a child with kwashiorkor may have include:

  • loss of appetite
  • changes in hair color, where it may look yellow or orange
  • dehydration
  • pitting edema or swelling, usually on the legs and feet, when a finger mark remains after the skin is pressed
  • lack of muscle and fat tissues
  • lethargy and irritability
  • dermatosis, or skin lesions that are cracked and patchy
  • frequent infections in the skin lesions

Sometimes, the edema a child has due to kwashiorkor can mask how emaciated they have become. The child may appear to be a normal weight or even plump, but this appearance is swelling due to fluid and not the presence of fat or muscle.

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Child standing on weighing scales
A doctor may check the weight of a child when diagnosing kwashiorkor.

When diagnosing kwashiorkor, doctors begin by taking a history and performing a physical examination of the child.

A doctor will look for the condition’s characteristic skin lesions or rash, as well as the edema on a child’s legs, feet, and sometimes their face and arms. They will also compare the child’s weight to their height.

Also, a doctor can order blood testing for electrolyte levels, creatinine, total protein, and prealbumin.

Typically, however, it is often possible to make a diagnosis of kwashiorkor just from a child’s physical symptoms and a description of their diet.

Children with kwashiorkor tend to have low blood sugar levels, as well as low protein, sodium, and magnesium levels.

Kwashiorkor vs. marasmus?

Doctors define acute malnutrition in three forms:

  • Marasmus: A severe weight loss and muscle wasting due to lack of nutrition and calories.
  • Kwashiorkor: Swelling or edema due to water retention.
  • Marasmic-kwashiorkor: A combination of muscle wasting and bilateral edema.

According to the worldwide relief organization Unicef, marasmus is the most common form of acute malnutrition in food shortage emergencies. This condition affects both children and adults.

All the above definitions are severe forms of malnutrition that require urgent treatment

What are the treatments?

While kwashiorkor is a condition related to malnutrition, merely feeding a child or adult will not correct all the deficiencies and effects of the condition.

If a child has gone without sufficient protein and nutrients for a long time, eating again can be a shock to their system if reintroducing food is not done carefully.

Many children with kwashiorkor will also develop lactose intolerance. As a result, they may need to avoid milk products or take enzymes so their bodies can handle milk.

Doctors treating the condition will first give carbohydrates, then add in proteins, vitamins, and minerals. The reintroduction of food may take a week or more to accomplish safely.

Additionally, if a child’s condition is so advanced that they are in shock with low blood pressure and a high heart rate, they may need to take medication to support their blood pressure.

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Kwashiorkor complications

Protein may be reintroduced gradually into the diet to avoid complications from kwashiorkor.
Gradually reintroducing protein may help prevent complications.

Lack of treatment for kwashiorkor can lead to the following complications:

  • coma
  • mental disabilities
  • physical disabilities
  • shock

If a child is severely malnourished and does not receive treatments, kwashiorkor can be fatal.

Death in cases of kwashiorkor is because a child becomes vulnerable to infections due to skin lesions and lack of nutrition to keep their immune system strong.


With treatment, a child can usually reverse many of the signs and symptoms of kwashiorkor. Delayed treatments can, however, result in physical and mental health problems over time.

Many children with kwashiorkor may not grow to an expected height due to malnutrition at an early age. If a child does not receive treatment, the condition can prove deadly.

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